It has recently been shown that deleterious economic changes constitute the most important sources of pathological trends in U.S. cities (and in the United States as a whole). At the same time, some cities show trends of extreme reaction to unemployment increases in terms of deteriorated mental and physical health, and criminal aggression, while many other cities show moderately strong reactions. City reactions to inflation are highly varied, with only a few showing severe pathology. Pathological reactions to rapid economic growth and to long term economic decline, however, are nearly always severe. Information on the questions of why economic changes have such a variable impact on urban pathology would allow us to uncover the mechanisms whereby economic change results in pathology. This study investigates the impact of national regional and local economic changes on a large sample (N-70) of American cities over the period 1940-75. The principal focus in on the differential impact of the economy on cities with varying demographic, industrial, community, ethnic and family structures. The fundamental question in the proposed analysis concerns the relative susceptibility (or resistance) of different cities to economic trauma in terms of their pathological trends. Explicitly tested are the two major theories of stress which argue that (1) severe stress situations within the past five years, and (2) community and family structure are the principal factors in pathological outcomes. Economic trauma is measured (through time-series and cross-sectional analyses) by economic decline or rapid growth (in real per capita income), unemployment, and inflation rates. The most severe (as well as valid and reliable) measures of pathology are used, including mortality rates by age, sex, and race, and mortality specifically due to suicide, homicide, cardiovascular disease, cirrhosis, and accidents. This macroscopic (as constrasted with individual-based) analysis of urban pathologies allows determination of whether stress associated with the national, regional and urban economic structures are mediated by prior urban-level stress and social support.